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Irritable bowel syndrome ... nutrigenomics.

Q. Recently, I was diagnosed with IBS, and I am having a difficult time with food. Can you please guide me on which foods I should avoid?

A. There is no one specific diet for irritable bowel syndrome (IBS); different foods can cause problems for different people. You will need to pay attention to the foods that make your symptoms worse. Common culprits include fatty foods, spicy foods, too much caffeine or alcohol, gas-forming foods, such as broccoli, cauliflower, beans, and cabbage, and sugar alcohols, such as sorbitol, which is found in many "diet" foods and gum.

In addition, research has demonstrated that foods high in FODMAPs can worsen symptoms in many people. "FODMAP" is an acronym for fermentable oligo-, di-, and monosaccharides and polyols. These are small-chain carbohydrates that can cause gas when fermented by bacteria in the large intestine and produce bloating, pain, diarrhea, or constipation in people with IBS. FODMAPs are found in the following groups of carbohydrates:

* Lactose: milk, yogurt, ice cream, cottage cheese

* Fructose: high fructose corn syrup, apples and apple juice, pears and pear juice, asparagus, cherries, honey, agave

* Fructans: wheat, rye, onion, garlic, inulin, chicory root

* Galactans: dried beans and peas, pistachio nuts, soybeans

* Polyols: sugar alcohols including sorbitol, mannitol, xylitol, and maltitol, apples (also a source of fructose), apricots, blackberries, figs, cauliflower, and mushrooms.

It is a good idea to keep a food/symptom log to help identify which foods cause problems. Keep in mind that it can take many hours for a food (or group of foods, as with FODMAPs) to produce or worsen symptoms. Learning to cope with IBS can be frustrating; it would be helpful for you to work with a doctor or registered dietitian familiar with the low-FODMAP diet to learn how to eliminate and reintroduce foods in a systematic way.

Q. What does "nutrigenomics" mean?

A. Nutrigenomics seeks to understand and develop optimal nutrition based on an individual's unique genetic makeup. It is the study of how nutrients from the foods an individual eats interact with his or her genetic makeup and alter how his or her genes are expressed. This ultimately creates a link between a person's nutrition, health status, and genetic makeup. This has led to the idea of personalized nutrition.

Unfortunately, a significant limitation to the study of nutrigenomics is the effect an individual's environment may have on his or her genes. As a result, alterations in gene expression could be associated with nutrition, but also with environmental factors.

Nutrigenomics should not be confused with nutrigenetics, which is the study of how a particular genetic variation responds to the intake of certain nutrients. In nutrigenomics, food affects the gene expression. In nutrigenetics, the genetic variation affects how a diet alters a person's health status.

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Title Annotation:ASK DR. ETINGIN
Publication:Women's Nutrition Connection
Date:Dec 1, 2013
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